| NPI | 1215225636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY RICHARDSON Vice President 228-392-4454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: MS 11075) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-10-19 |